Pharmacy Technician - Prior Authorizations - Work From Home
Core
Processes prior authorization requests via phone, fax, or electronically to support clinical reviews and ensure NCQA compliance.
Role type
Pharmacy Technician (Prior Authorizations)
Builds
Prior authorization approvals and denials for pharmacy benefit plans
Domain
Healthcare / Pharmacy Benefit Management
Deliverable
client delivery
Required skills
Drug name and diagnosis pronunciation, medical terminology, multi-system navigation, documentation, time management
Preferred skills
Retail or hospital pharmacy experience, managed care or Medicaid experience, AS400 system proficiency, Microsoft Office proficiency, clinical information reading
Technologies
AS400, Microsoft Excel, Microsoft Word, Microsoft Outlook
Responsibilities
Process prior authorization requests, complete expiring approvals/denials, review denial language for NCQA compliance, answer high-volume inquiry calls, maintain accurate documentation
Seniority
Individual Contributor